I am a plastic surgeon in Little Rock, AR. I used to "suture for a living", I continue "to live to sew". These days most of my sewing is piecing quilts. I love the patterns and interplay of the fabric color. I would like to explore writing about medical/surgical topics as well as sewing/quilting topics. I will do my best to make sure both are represented accurately as I share with both colleagues and the general public.

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Wednesday, March 2, 2011

Updated 3/2017-- photos and all links removed as many are no longer active and it was easier than checking each one.

Monday I happened to catch the NPR segment by Terry Gildea: Rebuilding The Faces Of War

And now, a story about the effects of war and violence in a different part of the world and how specialists are learning from it. The wars in Iraq and Afghanistan have created a need for innovative treatments for severe battle wounds. Service members often suffer injuries that disfigure and even eliminate parts of their face. At a Defense Department clinic in Texas, surgeons are restoring missing facial features and in a way they're restoring the identities of the wounded.

Texas Public Radio's Terry Gildea takes us to the clinic at Lackland Air Force Base in San Antonio. …

He's now working with doctors at the Maxillofacial Prosthetic Clinic at Wilford Hall Medical Center. Today his anaplastologist, Nancy Hanson, is fitting him with a new set of ears. …………..

……

The story notes that the Department of Defense has two such clinics. It mentions Lackland Air Force Base in San Antonio, TX but didn’t specify the other. It took some “googling” but I finally found an article that mentioned the other one:

The maxillofacial prosthetics program is only one of two such programs in the Defense Department, said Col. (Dr.) Alan Sutton, the program’s director. The other program is at the National Naval Medical Center in Bethesda, Md., he said.

While looking for the second clinic, I found this 2008 article on Air Force Senior Airman Justin Jones who at the time was a maxillofacial prosthetic technician with 59th Dental Squadron here. His job was to help service members who have suffered disfiguring facial injuries. [Face of Defense: Airman Helps Injured Warriors 'Face' World]

and this article from August 3, 2010: Air Force dental team helps patients ‘face’ the world, also featuring the MacKown Dental Clinic, which explains the process:

………Often most important to the patient is the restoration of function – speech, chewing and swallowing — in cases where injury or cancer to the mouth or jaws has occurred.

The team’s first step frequently starts in the stereolithography lab, located at MacKown Dental Clinic, which is one of only two located in the DoD.

Stereolithography is a rapid prototyping method, which allows the fabrication of anatomically accurate, three-dimensional epoxy and acrylic resin models from various types of medical data. There are myriads of data formats that can be assimilated, some of which include those from computed tomography, magnetic resonance imaging, and optical scanners.

“I can take a CT scan of a burn patient’s head and create an exact replica so our anaplastologist can build replacement ears and noses that will fit perfectly,” said Mr. Dave Carballerya, stereolithography lab supervisor. “This technology is also used to incorporate dental and craniofacial implants to enhance the doctors’ diagnosis and treatment planning.”

The team’s anaplastologist then works to create facial prosthetics for the patient.

Anaplastology is the art and science of restoring a malformed or absent part of the human body through artificial means. Again, Lackland is unique in that MacKown Dental Clinic employs the only certified clinical anaplastologist in the DoD, Ms. Nancy Hansen.

“Our patients are going through the traumatic experience of missing anatomical features,” said Ms. Hansen. “We get to see them blossom because they are given hope.”

Ms. Hansen begins by making an impression of the area of the missing anatomy. Prosthetic noses, ears, jaws, even eyes can be made with silicone or hard resin. Many steps are taken to give the prosthesis a realistic look. …………

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